"The biggest shift was the consolidation that happened with the insurance carriers themselves. From 25 or more carriers to just four national carriers." - John Rutledge

How did health insurance get so broken? My guest this week, 40-year industry veteran John Rutledge of Marsh McLennan Agency, joins the show to walk us through the last 40 years of decisions that led us to the consolidated, expensive, and frustrating market we have today.

John explains how the market went from over 25 competing carriers to just four national players. We discuss how the rise of carrier-owned PPOs squeezed out competition, and how the ACA later standardized coverage, locking employers into the "Buca box" with painfully limited options.

But this isn't just a history lesson. We also discuss the solution that has emerged from the ashes of the old system: the explosion of self-funding and alternative risk models like captives that empower employers to finally break free.

Tune in for a masterclass on how health insurance was broken, and more importantly, how we can start to fix it.

Chapters:

(00:00:00) How Health Insurance Was Broken Over The Last 40 Years

(00:05:01) Why Self-Funding Has Exploded Since the ACA

(00:09:58) How We Went From 25+ Carriers to Just 4

(00:12:56) The "Buca Box": Trapped with No Options

(00:31:04) The Rise of Captives as an Alternative

(00:40:31) Why Engaged Employers Win in a Captive

(01:00:56) A Call to Action for Employers & Advisors

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"Eat your food as medicine or medicine will become your food." - Chef Austin Simmons

Can better beef solve America's health crisis? My guests this week, Chef Austin Simmons of Chef and Rancher and benefits/nutrition expert Chris Pierron, believe it's a critical part of the solution. They join the show to discuss the deep connection between cattle genetics, our broken food system, and our exploding healthcare costs.

Chef Austin explains his "hoof to fork" model for creating "better beef." We discuss how using purebred, genetically-verified cattle and clean feeding practices, free of the seed oils and used fryer oil common in the commercial industry, produces a more nutrient-dense and flavorful product.

This isn't just about a better steak; it's about creating a healthier population from the ground up. We explore how fixing the food system is the most important step to lowering healthcare costs, and why consumer education is the key to driving this change.

Tune in today for a conversation that will change the way you think about the beef on your plate.

Chapters:

(00:00:00) How Better Beef Can Solve America's Health Crisis

(00:05:18) The Hidden Additives & "Poisons" in Most Beef

(00:19:38) Why is Prime Beef So Inconsistent?

(00:20:58) The Power of Cattle Genetics

(00:37:47) Is There Used Fryer Oil In Your Steak?

(00:54:22) Should We Federally Subsidize Beef?

(01:02:09) Why Food Education is the First Step

(01:13:26) Fixing the Food System to Fix Healthcare

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"If we can remove the cost barrier, folks are going to engage more because it's not standing in the way of going to get the care that they need or even preventive care." - Trey Smith

High healthcare deductibles were sold to employers as a way to create better "consumers" of healthcare. My guest this week, Trey Smith of Hub International, argues that they've been a failed experiment that has done more harm than good. Instead of creating smarter shoppers, high deductibles have become a massive barrier to care, causing employees to delay or avoid necessary treatment altogether.

In this episode, Trey breaks down the alternative: first dollar coverage.

We discuss how innovative plan designs with zero deductibles can actually lower an employer's overall claim spend over time by encouraging early intervention and proactive care. He shares data showing that while utilization spikes initially, long-term costs come down significantly as members get the care they need when they need it.

This conversation is a perfect example of why the benefits consultant's role is shifting from simply brokering insurance to designing strategic solutions that solve real problems for employees and employers. I hope you'll tune in!

Chapters:

(00:00:00) High Healthcare Deductibles Are A Failed Experiment

(00:26:16) The Risk of Innovation vs. The Risk of the Status Quo

(00:29:59) The Problem: High Deductibles as a Barrier to Care

(00:34:10) The Solution: "First Dollar" Coverage

(00:38:22) Simplifying the Healthcare Experience

(00:52:17) How Data is Making New Plan Designs Possible

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/